Care Coordinator
3 days ago
Job Summary:
The Utilization Management Care Coordinator plays a crucial role in a multidisciplinary care team, assisting with the care of members enrolled in our Managed Long Term Care program and facilitating authorization requests for eligible members.
Key Responsibilities:
- Assists in the prior authorization of services and ongoing authorization requests
- Completes authorization updates as needed based on the care plan of the member
- Coordinates with providers regarding authorization activities
- Communicates with authorization clinical staff, members, and providers as needed
- Acts as a liaison and member advocate between the member/family, physician(s), and the care team to ensure timely and effective communication in regards to the member's care
- Participates in case round meetings and ongoing education activities
- Ensures that all job responsibilities are carried out in compliance with CPHL and State and Federal regulations
Requirements:
- HS Diploma
- Strong written and verbal communication skills
- Computer proficiency
- Strong multi-tasking abilities
Preferred Qualifications:
- Experience working within a managed care environment
- Computer proficiency in Microsoft Office applications
Centers Plan for Healthy Living:
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other characteristic protected by law.
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